Ch 14 shoulder conditions

Epiphysis of the proximal humerus

Little league shoulder is found at the

Immobilization with a figure 8 brace & sling and application of cold

An on field eval if an injury sustained by a hs lacrosse player suggests a grade 2 SC sprain, what is the immediate management for this injury?

ROM of glenohumeral internal and external rotation

Apley scratch test is used primarily to determine

Application of ice, prescribed NSAIDS, and use of a cervical collar

A basketball player has sustained a grade 2 strain to the right upper trapezius. The immediate management for this condition should include what?

A fall on an outstretched arm

A common mechanism for an AC sprain is:

Immobilization, immediate physician referral, and application of ice

A hs basketball player sustains a first time anterior glenohuneral dislocation. Immediate management for this condition is what?

Inability to actively abduct the arm between 70-120 degrees

A painful arc involving the shoulder is characterized by an

Supraspinatus

A patient has a subacrominal impingement, what muscle could be weak due to this condition?

Clunk test and compression rotation test

A softball pitcher reports painful clicking and popping in her pitching shoulder. Based on the initial findings in assessing the condition, the AT suspects a tear of the glenoid labrum. Which tests should the AT perform to rule out this suspicion?

In the first 30 degrees of abduction

An AT determines that an individuals rehab program needs to include exercises for strengthening the supraspinatus muscle. This can be accomplished through light resistance exercises performed:

Flattened deltoid

An anterior glenohumeral dislocation outwardly displays:

Posterior displacement of the SC joint

An athlete sustained a blow to the posterolateral aspect of the shoulder with the arm addicted and flexed. He come soft the field reporting difficulty breathing and swallowing. The ATs eval reveals a palpable depression between the sternum end of the clavicle and manubrium, inability to perform shoulder protraction and a diminished radial pulse. What injury should be suspected?

Hills-Sachs lesion

Common finding after an anterior glenohumeral dislocation is:

Recurrent shoulder dislocations

Dead arm syndrome is associated with :

Axillary

During a glenohumeral dislocation, the function of what nerve should be assessed?

Wrist flexion and extension

During a shoulder exam, the AT notes muscle weakness associated with the C6 myotome. Which motions contributed to this finding?

Abduction and flexion

During the initial rehab for a type 3 AC joint sprain, what two motions should be limited to 90 degrees

Gathered position

During the throwing motion of a pitcher, when the arms are raised overhead, it is referred to as the

Stage 3

During which stage of a shoulder impingement syndrome is there noticeable atrophy of the supraspinatus and infraspinatus?

Scapulothoracic joint

Elevation and depression are most prominent at the:

Type 2 SC sprain

Following a pile-up during a rugby game, an athlete slowly comes off the field, holding his L. Arm. forward and close to the body, supporting it across his chest. The ATs exam reveals instability to horizontal adduct the arm without considerable pain. What injury should be suspected?

Clavicular fracture

Following a tackle, a soccer player comes off the field in obvious pain. His head turned to the right side and he is supporting his right arm with his left arm. What injury should be suspected?

Thrombophlebitis

If thoracic outlet syndrome is left untreated, it can lead to what complication?

Slightly abducted and externally rotated

In a first-time anterior glenohumeral dislocation, the injured arm is usually held in which position?

Distal clavicle

In an acromioclavicular separation, the ------- is elevated

Acceleration

Most injuries to the rotator cuff occur during which phase of the throwing motion?

80-90 degrees

Normal ROM for shoulder lay or ext rot is

Bicipital tendinitis

Pain and tenderness over the bicipital groove when the shoulder is internally and externally rotated may be indicative of what?

Apprehension on the part of the patient

Positive test for clunk test?

Flexion and extension

Sagittal plane movements of the humerus at the shoulder include

33%

Scapulohumeral movement contributes to approximately --- of the total rotational movement of the humerus

An undescend scapula

Sprengels deformity presents as

Piano key sign &a the distal clavicle will move and be painful

The AT applies downward pressure on the lateral clavicle. What name is given to this test and what findings constitute a positive test?

Bicipital tendinitis

The AT performs an eval on a 20 yr old shot putter and both the speeds & yergasons tests were positive. What pathology does this result indicate?

Integrity of the supraspinatus muscle

The drop arm test is used to determine what?

25 years of age

The epiphyseal plate of the medial clavicle does not close until approximately what age?

Rotator cuff muscles

The head of the humerus is held against the glenoid fossa by the:

Shoulder abduction

The myotome for C5 is:

Glenohumeral joint

The true shoulder joint is referred to as the:

Aching pain in the back of the neck that extends down the medial arm to the ulnar aspect of the hand, weakness in grasping of the hand, and atrophy of the hand muscles

What are the 3 most common s&is associated with TOS

Biceps brachii, Coracobrachialis, Anterior deltoid, and pectoralis major

What are the four muscles for shoulder flexion?

Provide increased proprioceptive/ kinesthetic feedback, result in less shear forces, &can exercise multiple joints

What are three advantages of performing closed-chain exercises?

Allen, costoclavicular syndrome & adson

What are three eval tests for TOS

Brachial plexus injury and vascular injury

What are two potential early complications of a fracture to the proximal humerus?

Neer test and Hawkins Kennedy test

What are two tests for shoulder impingement?

Overhead throwing motion

What is a common mechanism of injury to the Subacrominal bursa?

Tear or weakness of the subscapularis

What is the lift-off test assessing?

Rhomboid

What muscle plays a major role in positioning the scapula to facilitate the throwing motion

AC ligament and Coracoclavicular ligament

What two ligaments are completely disrupted with a Type 3 AC sprain?

Fibrocartaginous

What type of structure is the glenoid labrum

Triceps brachii

When testing the c7 reflexes, the tendon tapped with the reflex hammer is the

Scapula

Which bony structure articulates with the acrimion?

Pectoralis major (clavicular)

Which muscle is the primary adductor for glehumeral flexion?

Subscapularis, infraspinatus, teres minor, supraspinatus

Which muscles comprise the SITS group?

Long thoracic nerve

Which nerve is associated with Serratus Anterior weakness or winged scapula

C5-T1

Which nerve roots make up the brachial plexus?

Push ups

Which of the following is an example of closed kinetic chain exercise that can be used in shoulder rehab?

The dorsal surface of the middle finger

Which of the following is the C7 dermatome?

SITS muscles

Which soft tissue structures assist in rotating the humerus and form a collagenous cuff around the glenohumeral joint?

Rupture of the proximal long head of the biceps tendon

While performing a bicep curl, a 50 ye old male felt a snapping sensation and intense pain. Ecchymosis and a "popeye" appearance are visible in the distal arm. He has pain and weakness in elbow flexion and supination. What injury should be suspected?

Due to the extreme ROM of the joint

Why is the glenohumeral joint considered to be the least stable joint in the body?